office of statewide health planning and …...san diego sacramento los angeles - orange california...

OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENTPRESENTATION TO THE LITTLE HOOVER COMMISSION

CALIFORNIA’S PUBLIC HEALTH INFRASTRUCTURE IN TIMES OF CRISIS(Hearing date June 27, 2002)

Presenter: David M. Carlisle, M.D., Ph.D.Director, Office of Statewide Health Planning and Development

Purpose: To address the Commission’s expressed concerns regarding 1) “capacityconcerns related to serving the public health needs of Californians” and 2) “Theperspective of the Office of Statewide Health Planning and Development relatedto the public health preparedness of our state.”

Overview: OSHPD works toward equitable healthcare accessibility for California throughmany different avenues. OSHPD is responsible for a variety of programs thataddress healthcare workforce needs, improve healthcare quality, provideaccurate and timely data and information products for healthcare planning andanalysis, and support safe healthcare facilities.

Capacity of Public Health Infrastructure

A. Facilities

1. General Acute Care Hospital Capacity (by state, region & county)a. Number of available general acute care bedsb. Number of available general acute care beds per 1,000 populationc. Occupancy rates

2. Hospital Emergency Department Capacity (by state, region & county)a. Location of hospitalsb. Location of emergency departments

• Level of service• Location of trauma centers• Location of hospitals with helicopters• Location of hospitals with burn units

c. Number of ED treatment stationsd. Number of ED treatment stations per 1,000 pop

3. Hospital Seismic considerationsa. Location of SPC 1 buildingsb. Emergency response team for natural or manmade calamity

B. Capacity of Healthcare Workforce (by state, region & county)

1. Designation process for medical underservedness2. Location of Health Professional Shortage Areas3. Location of Medically Underserved Areas4. Location of Medically Underserved Populations

California’s PublicHealth Infrastructure in

Times of Crisis

byDavid M. Carlisle, M.D., Ph.D.

Presentation to

Little HooverCommission

June 27, 2002

1

The Office of StatewideHealth Planning &

Development:• Develops data and

information products forhealthcare planning;

• Supports thedevelopment of safehealthcare facilities;

• Administers programsthat address healthcareworkforce needs.

2

California’s Public HealthInfrastructure in Times of

Crisis:Capacity of

General AcuteCare Hospitals

3

South East

North

Central East

Central Coast

Bay Area

Central Valley

Fresno - Madera

San Diego

Sacramento

Los Angeles - Orange

California Healthcare Infrastructure:General Acute Care Hospitals and Emergency Departments

0 100 20050 Miles

Hospital Offering Emergency Medical Services

Other General Acute Care Hospital

California Regions

Source: California Office of Statewide Health Planning and Development

4

South Eas t

North

Ce ntral Eas t

Ce ntral Coas t

Bay Are a

Ce ntral Valle y

Fre s no - Made ra

San Die g o

Sac rame nto

Los Ang e le s - Orang e

California Regions

0 100 20050 Miles

5

Available Beds per Capita by Region

0 100 20050 Miles

Available Beds per 1,000 Population1.8 to 2.1 Beds per 1,000 Population

2.1 to 2.4 Beds per 1,000 Population


2.6 to 2.8 Beds per 1,000 PopulationNorth

SacramentoCentral Valley

Bay Area

Fresno - Madera

Central East

Central Coast


South East

San Diego

6

53%

59%

62%

57%

62%

55%

58%

63%

58%

64%

Regional Occupancy Rates

0 100 20050 Miles

Available Beds per 1,000 Population1.8 to 2.1 Beds per 1,000 Population




Occupancy rate for available beds in each region

North

Sacramento Central Valley

Bay Area

Fresno - Madera

Central East

Central Coast


South East

San Diego

7


Crisis:Hospital

EmergencyDepartment

Capacity

8

9

Los Ang e le s - Orang e

Sac rame nto

San Die g o

Fre s no - Made ra

Ce ntral Valle y

Bay Are a

Ce ntral Co as t

Ce ntral Eas t

North

South Eas t

Medical Service Status

0 100 20050 Miles

Medically Underserved Area

Medically Underserved Population

Area Not Designated

California Regions


Emergency Department Treatment Stationsper Capita by Region

0 100 20050 Miles

Treatment Stations per 1,000 Population0.12 to 0.15 Stations per 1,000 Population

0.16 to 0.20 Stations per 1,000 Population



North


Bay Area

Fresno - Madera

Central East

Central Coast


South East

San Diego

10


Crisis:Hospital SeismicConsiderations

11

12


Sacramento

San Diego

Fresno - Madera

Central Valley

Bay Area

Central Coast

Central East

North

South East

Hospitals Rated Seismically Compliant until 2030

0 100 20050 Miles

Hospital with no SPC 1 Buildings

California Regions


SPC Ratings and % of Available Beds, By Region

% of Available Beds byRegion, in Hospitals with no

SPC-1 Buildings:

19San Diego21South East21LA-Orange29Central Coast18Central East39Fresno-Madera24Central Valley35Bay Area45Sacramento27North%Region

13

14


Sacramento

San Diego

Fresno - Madera

Central Valley

Bay Area

Central Coast

Central East

North

South East

Hospitals Posing a Significant Collapse RiskFollowing a Strong Earthquake

0 100 20050 Miles

Hospital with 100% SPC 1 Buildings

California Regions



% of Available Beds by Region,in Hospitals Posing a SignificantCollapse Risk Following a Strong

Earthquake (100% SPC-1Buildings):

2San Diego4South East

18LA-Orange5Central Coast0Central East1Fresno-Madera

14Central Valley16Bay Area

0Sacramento8North

%Region

15

16


Sacramento

San Diego

Fresno - Madera

Central Valley

Bay Area

Central Coast

Central East

North

South East

Hospitals with Mixed Seismic Ratings

0 100 20050 Miles

Hospital with Mixed Seismic Ratings

California Regions

(Excludes any Hospital with 100% SPC 1 Buildings)


Hospitals Excluding Those atGreatest Risk of Collapse

Hospital with other than 100% SPC-1 buildings


% of Available Beds byRegion, in Hospitals

Excluding Those at GreatestRisk of Collapse

(Excludes 100% SPC-1 Hospitals):

81San Diego79South East79LA-Orange71Central Coast82Central East61Fresno-Madera76Central Valley65Bay Area55Sacramento73North%Region

17

EmergencyResponse Team

• In the event of a seismicevent, or other natural ormanmade disaster,OSHPD will send three-person teams to evaluatethe hospital structure andsystems.

• Team findings:– Red tag=Hospital building

unsafe; Evacuate immediately.– Yellow tag=Hospital building

may have limited occupancy.– Green tag=Hospital building

found safe for use andoccupancy. 18


Crisis:California’sHealthcareWorkforce

19

• Health professional shortagearea (HPSA)– Identifies areas of underserved

populations for primary care, dentaland mental health services >3,500:1 population to primary carephysician (exceptions made forareas with unusually high needs)

• Medically underserved area orpopulation (MUA/MUP)– Measures the degree of

underservice by poverty rates,percentage of pop > 65, infantmortality and population to providerratios

• Note: areas must apply forthese designations

20

Health Professional Shortage Area (HPSA) Status

0 100 20050 Miles

Designated Primary Medical Care HPSA

Area Not Designated

California Regions

North


Bay Area

Fresno - Madera

Central East

Central Coast


South East

San Diego

21

Medical Service Status

0 100 20050 Miles

Medically Underserved Area

Medically Underserved Population

Area Not Designated

California Regions

North


Bay Area

Fresno - Madera

Central East

Central Coast


South East

San Diego

22

California’s PublicHealth Infrastructure in

Times of Crisis

23

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